Immediate performance of self-etching versus system adhesives with multiple light-activated restoratives

Objectives: The purpose of this study was to evaluate the performance of both single and double applications of (Adper Prompt L-Pop) self-etching dental adhesive, when used with three classes of light-activated restorative materials, in comparison to the performance of each restorative system adhesive. Evaluation parameters to be considered for the adhesive systems were (a) immediate marginal adaptation (or gap formation) in tooth cavities, (b) free setting shrinkage-strain determined by the immediate marginal gap-width in a non-bonding Teflon cavity, and (c) their immediate shear bond-strengths to enamel and to dentin. Methods: The maximum marginal gap-width and the opposing-width (if any) in the tooth cavities and in the Teflon cavities were measured immediately (3 min) after light-activation. The shear bond-strengths to enamel and to dentin were also measured at 3 min. Results: For light-activated restorative materials during early setting (<3 min), application of Adper Prompt L-Pop exhibited generally superior marginal adaptation to most system adhesives. But there was no additional benefit from double application. The marginal-gaps in tooth cavities and the marginal-gaps in Teflon cavities were highly correlated (r=0.86-0.89, p<0.02-0.01). For enamel and dentin shear bond-strengths, there were no significant differences between single and double applications, for all materials tested except Toughwell and Z 250 with enamel. Significance: Single application of a self-etch adhesive was a feasible and beneficial alternative to system adhesives for several classes of restorative. Marginal gap-widths in tooth cavities correlated more strongly with free shrinkage-strain magnitudes than with bond-strengths to tooth structure.